Direct Insurance Billing
A good proportion of dental practitioners in Calgary no longer accept direct payment from insurance companies due to challenges in collection from these companies, numerous and varied benefit plans, and confusion regarding treatment that may or may not be covered under individual plans.
As a service to our patients, we will collect directly from the insurance company, any portion of your treatment that is covered by your insurance plan. You are responsible for your portion after each appointment.
There are many insurance companies in Canada, and each of them offers many different dental packages they sell to their clients (employers). Each package has its own coverage, percentage covered, deductible, individual fee guide, limitations, etc.
Your dental insurance is a contract between your employer and the insurance company, to assist you in the cost of dental treatment. They have designed the individual plan based on the type of coverage your employer has contracted, not on your individual dental needs. In this way, there may be significant differences between what your insurance provides coverage for, and treatment the dentist may recommend for you.
While we make every effort to gather detailed information regarding your insurance coverage, our treatment plan is based on the patient’s needs, not on his or her insurance coverage.
Ultimately, you are responsible for the costs of services provided. We will inform you, to the best of our ability when, a treatment may not be covered, the yearly maximum is close to be all used up, extensive treatment that is beyond your coverage. An estimate will be provided to you and discussed at that time.
Credit Card Policy
In order to “Direct Bill” your insurance company, we require a credit card on file for any outstanding amounts owing after your insurance plan has paid its portion.
Each insurance company has its own fee guide, which they use to calculate your coverage. They will pay for treatment based on a percentage of their fee guide, not a percentage of our office’s fees. Because of this, it is sometimes not possible to estimate the exact amount to be reimbursed by your insurance. On occasions when your insurance company electronically sends us a detailed explanation of payment, we will be able to determine the exact amount owing on the day of your appointment. However, if we don’t receive an explanation of payment, we will estimate your portion for that day. As a result, there may be a balance owing after your insurance payment. We will charge the balance owing to your credit card on file for any amount under $100.00. For amounts greater than $100.00, we will give you a courtesy call, to let you know, prior to processing the payment.
A receipt will be mailed to you for your records.